Surgical instrument

ABSTRACT

The invention relates to a surgical instrument, in particular a sliding shaft instrument, with a main part, and a moveable part relative thereto, with a handle attached to the main part, comprising a fixed grip and a grip actuating the moveable part, with at least one guide, through which, in relation to the main part, the moveable part is moveable between an initial position and a working position, and with a sliding surface attached to the movable part and pointing towards the main part, the sliding surface being slid along a guide surface attached to the main part and pointing towards the sliding surface, with at least the sliding surface or the guide surface are assigned to each other for the formation of a washable gap.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. No. 12/925,424, inventors Thomas Tontarra et al., filed Oct. 21,2010, the disclosure of which is incorporated herein by reference.

The invention relates to a surgical instrument, in particular a slidingshaft instrument, with a main part, and a moveable part relativethereto, with a handle attached to the main part, comprising a fixedgrip and a grip actuating the moveable part, with at least one guide,through which, in relation to the main part, the moveable part ismoveable between an initial position and a working position, and with asliding surface arranged on the movable part and pointing towards themain part, the sliding surface being slidable along a guide surfacearranged on the main part and pointing towards the sliding surface.

Surgical instruments of this type are used, for example, in the removalof tissues, bones or similar. At the outset of development of surgicalinstruments of this type, these surgical instruments were not able to bedismantled. Thus there was a disadvantage in that after a surgicalprocedure, these surgical instruments could not be completely cleanedand sterilised, particularly in the region of the guides between themoveable part and the main part, as well as between the sliding andguide surfaces of the moveable part and the main part.

A bone punch which is able to be dismantled is known in DE 297 18 969U1, in which, on the actuatable grip pointing to the moveable part, anopen-edged slit is formed, which engages into a recess in the moveablepart in order to incorporate a pivot fixed thereto. Through a detachablearrangement of the spring element between the actuatable grip and thefixed grip, it can be made possible for the actuatable grip to befurther expandable from a rest position, and therefore moves themoveable part further backwards towards the main part, so that the pilotpins of the moveable part are released from the guide of the main part.In connection to this, the moveable part can be removed from the mainpart, whereby both parts can be cleaned separately and subsequentlysterilised. This arrangement is disadvantageous in that the dismantlingand assembly are time-consuming. Additionally, there is also the problemthat when several surgical instruments are cleaned simultaneously, theallocation of the respective moveable part to the shaft istime-consuming. This allocation is necessary, therefore, since the mainpart and the moveable part are brought to a collective finishingoperation, and on a mix-up of the moveable parts in the region of thegap, which is formed by the sliding surface and the guide surface,overhangs can occur, which can result in injuries.

In order to avoid this disadvantage, a surgical instrument is known inDE 199 49 422 A1 in which, indeed, it is made possible to remove themoveable part from the main part for cleaning the surgical instrument,however the moveable part remains firmly attached to the main part by ahinge joint. Therefore, the problem of allocating the moveable parts tothe respective main parts is eliminated. However, the necessaryexpenditure of time remains in order to separate the moveable part fromthe main part, in order to clean and to sterilise the surgicalinstrument, as well as the subsequent assembly.

Therefore, the object of the invention is to create a surgicalinstrument, in particular a sliding shaft instrument, which facilitatescleaning and sterilisation, without requiring the surgical instrument tobe dismantled, also even partly, for the cleaning process.

This object is achieved by a surgical instrument having a sliding shaftinstrument, with a main part and a relative moveable part, with a handlearranged on the main part, the former having a fixed grip and a grip foractuating the moveable part, with at least one guide through which themoveable part relative to the main part is moveable between an initialposition and a working position, and with a sliding surface pointing tothe main part and arranged on the moveable part, the sliding surfacebeing slidable along the guide surface, pointing to the sliding surfaceand arranged on the main part and at least the sliding surface or theguide surface are arranged with each other for the formation of awashable gap.

Further advantageous embodiments and further developments are given inthe further dependent claims.

The embodiment of the surgical instrument according to the invention, inwhich at least the sliding surface of the moveable part or the guidesurface of the main part are reduced to a width for forming a washablegap, has the advantage that after use of the surgical instrument, nofurther handles are required in order to dismantle the surgicalinstrument, so that this surgical instrument can be cleaned andsterilised. A subsequent assembly for the next use is also omitted.Therefore cleaning of the surgical instrument is possible withoutdismantling.

Furthermore, the embodiment according to the invention has the advantagethat through the reduction of the sliding and guide surfaces whichborder each other, a reduction of the sliding friction force between themain part and the moveable part is also made possible, whereby animprovement of the operating characteristics or a smoother movement ofthe moveable part to the main part is given. The same is valid for theallocation to each other for the formation of a washable gap. The sameapplies for any combination of these alternatives.

Furthermore, the embodiment according to the invention makes it possiblethat the crucial regions of a surgical instrument, in which bacteriaaccumulate, are accessible, or can be washed in a washing machine withwashing water, and preferably subsequently sterilised. Therefore thedismantling of the surgical instrument is unnecessary.

In a further preferred embodiment of the invention, it is intended thatat least the guide surface or the sliding surface is open in a spatialdirection. A preferred spatial direction is in a longitudinal direction,or in a transverse longitudinal direction of the main part and moveablepart, whereby the spatial direction preferably lies in a parting planebetween the main part and the moveable part. This represents a firstsimple embodiment, and facilitates the maintenance of the presentoperation of the surgical instrument. In this embodiment, this takesplace particularly through the opening of at least the guide surface orsliding surface in a spatial direction, for example in the form of arecess.

In a further preferred embodiment of the invention, it is intended thatat least the sliding surface or the guide surface are assigned to eachother for the formation of a washable gap. Therefore, inter alia, a jetaction can take place in a washing process, in order to improve thecleaning. In this embodiment, at least the surface portions borderingeach other between the sliding surface and the guide surface are soreduced, that on cleaning the surgical instrument in a washing machine,the spray streams used in the cleaning process suffice, if necessary, inorder to wash out bacteria or other impurities found in this gap.

According to a preferred embodiment of the invention, at least one bevelbordering the guide surface or the sliding surface is provided on atleast one external side of the main part or the moveable part, the bevelbeing inclined at least in portions to the longitudinal centre line.Therefore the width of the sliding surface and/or the guide surface isreduced. For example, for a bevel arranged on the moveable part, theedge formed between the sliding surface and the bevel is positionedinward or towards the longitudinal centre line opposite the edge betweenthe guide surface and an external side of the main part, so that seen incross-section, a relief develops, in particular a recess in triangularform. Therefore, on impact of a spray stream on the surgical instrument,the spray stream is led towards the gap between the sliding surface andthe guide surface, so that an improved cleaning of the gap or theopening or recess is made possible. This effect is particularlyimproved, then, if a bevel of this type is arranged symmetrically aboutthe cleavage plane, which is formed by the sliding and guide surfaces.Therefore the spray stream can be targeted to the gap. Simultaneously,when using a surgical instrument of this type, there is no damage causedto the tissues surrounding the shaft.

According to a further preferred embodiment of the invention, a bevel isprovided on each external side bordering the sliding or guide surface,and this bevel is formed preferably mirror-symmetrically about thelongitudinal centre line, and in particular, to the gap. Therefore, forexample, seen in cross-section, a geometry in the form of a truncatedcone can be formed, whereby the gap width between the sliding surfaceand the guide surface can be considerably reduced compared to surgicalinstruments according to the prior art. In this way, the reduced widthof the bevel and this reduced width of the guide surface can be providedequally or differing from each other.

Furthermore, it is preferable that a bevel is provided on only oneexternal side, with the bevel substantially extending over the wholewidth of the main part or moveable part, so that the sliding surface andguide surface directly border an external side and are reduced in widthto form a washable gap. This embodiment has the advantage that a maximalsize of orifice or incoming area for the spraying liquid is given in theremaining gap between the main part and the moveable part. Additionally,the opposite external side can be designed as almost closed.

In a further preferred embodiment, it is intended that at least thesliding surface or guide surface is opened by a recess extendingtransversely across the longitudinal extent of the main part andmoveable part. Through recesses of this type, the gap formed between themoveable part and the main part is completely disconnected. Thus thisregion is particularly easy to clean. Preferably, between the guidesand/or hinge joints, and in particular recesses extending across thelongitudinal extent of the main part and moveable part are provided atleast in portions in the sliding surface and/or the guide surface.

In an alternative embodiment of the invention, it is intended that atleast the sliding surface or the guide surface is opened by a recessextending in a longitudinal direction of the main part and moveablepart. This alternative embodiment has the advantage that the surgicalinstrument, in particular the sliding shaft, can maintain the currentappearance of conventional surgical instruments, that is to say, thatthe external sides of the moveable part and the main part are mergedinto one another in a flush manner, however the advantages of theinvention are given. In this way, for example, a recess in the form of alongitudinal channel or through-channel can be formed, whereby thecleaning and spraying liquids are introduced at the proximal or distalend, and are brought out at the opposite side in each case.Simultaneously, a side release over the remaining and washable gapbetween the sliding surface and the guide surface can take place.

In an advantageous further development, it is intended that the recesshas an undulating form. Therefore, larger regions on the sliding orguide surface to the opposite surface or on both surfaces can beomitted, and thus are easily accessible for cleaning. Alternatively, therecesses can have a triangular, rectangular, trapezoidal, hemisphericalor sawtooth form. Recesses of this type are particularly formed in thisway, in that these deepen from the sliding or guide surfaces from themoveable part or the main part. This embodiment makes it possible thatthe opposite external side of the moveable part or main part has aclosed top, and a sufficient full cross-section remains, in order to cuttendons or to facilitate the cutting of tissues or similar. The recessescan be uniform or can be combined with each other.

In an alternative embodiment for the recesses, it is intended that theseare designed between two elevations arranged so that they areneighbouring each other, which are in a truncated cone form,frustropyramidal form, hemispherical form or in the form of a crescentsegment. Therefore, further geometric alternatives for the production ofthe recess are given, which facilitate easy cleaning as well as a lowercontrol force for actuating the surgical instrument.

According to a further preferred embodiment of the invention, it isintended that at least one recess or a bevel borders a guide. In theprocess, the guide between the moveable part and the main part canconsist of, for example, a T-shaped guiding groove or a similarly shapedguiding groove on the one hand, and on the other hand, a complementarydesigned pilot pin is intended. Furthermore, the guide can be formed bya hinge joint or a double joint between an actuatable grip and themoveable part. Through the adjacency of the recess or the bevel to theguide, it is ensured that these regions are accessible for the cleaningliquid and the subsequent disinfection.

The invention as well as further advantageous embodiments and furtherdevelopments of the same are described in more detail and explainedbelow by means of the examples represented in the drawings. The featuresto be taken from the description and the drawings can be appliedindividually or in any combination according to the invention. In thedrawings:

FIG. 1 shows a schematic side view of a surgical instrument according tothe invention,

FIG. 2 shows a schematic enlarged side view of the surgical instrumentaccording to FIG. 1,

FIG. 3 shows a schematic enlarged section view of the surgicalinstrument according to FIG. 1,

FIG. 4 shows a further schematic enlarged section view of the surgicalinstrument according to FIG. 1,

FIG. 5 shows a schematic enlarged side view of an embodiment alternativeto FIGS. 2, 3 and 4,

FIG. 6 shows a schematic enlarged section view of the embodimentalternative to FIG. 5,

FIG. 7 shows a schematic enlarged side view of an embodiment alternativeto FIGS. 2, 3 and 4,

FIG. 8 shows a schematic enlarged section view of the embodimentalternative to FIG. 7,

FIG. 9 shows a schematic enlarged side view of an embodiment alternativeto FIGS. 2, 3 and 4,

FIG. 10 shows a schematic enlarged section view of the embodimentalternative to FIG. 9,

FIG. 11 shows a schematic enlarged side view of an embodimentalternative to FIGS. 2, 3 and 4,

FIG. 12 shows a schematic enlarged section view of the embodimentalternative to FIG. 11,

FIG. 13 shows a schematic enlarged side view of an embodimentalternative to FIGS. 2, 3 and 4,

FIG. 14 shows a schematic enlarged section view of the embodimentalternative to FIG. 13,

FIG. 15 shows a schematic enlarged side view of an embodimentalternative to FIGS. 2, 3 and 4,

FIG. 16 shows a schematic enlarged section view of the embodimentalternative to FIG. 15,

FIG. 17 shows a schematic enlarged side view of an embodimentalternative to FIGS. 2, 3 and 4,

FIG. 18 shows a schematic enlarged section view of the embodimentalternative to FIG. 17,

FIG. 19 shows a schematic side view of an alternative embodiment of asurgical instrument according to FIG. 1,

FIG. 20 shows a schematic enlarged side view of the surgical instrumentaccording to FIG. 19,

FIG. 21 shows a schematic enlarged section view of the surgicalinstrument according to FIG. 19, and

FIG. 22 shows a partial schematic rear view of the surgical instrumentaccording to FIG. 19.

A first embodiment of a surgical instrument 11 according to theinvention is shown in FIG. 1 and FIGS. 2 through 4. This surgicalinstrument 11, relates to a sliding shaft instrument, for example, aso-called punch, in particular Kerrison punch, which is used in surgicalprocedures for the removal of bone tissues or similar. The invention isnot limited to these punches, but can be applied to all surgicalinstruments which have the same problems regarding cleaning andsterilisation.

The surgical instrument 11 has a main part 12, which is also referred toas a shaft. This main part 12 incorporates a moveable part 14, which isslidable relative to the main part 12. The moveable part 14 is alsonamed as a slide. Functional elements 16, 17 are provided at theproximal end of the main part 12 and the moveable part 12. This can be ablade and a counter plate or counter-cutter, for example. Equally, inother embodiments, this can be a scissor-type cutting tool, aspatula-shaped cutting tool or grasping forceps or similar. Thearrangement of the functional elements 16, 17 is custom designed for thesurgical procedure.

A handle 18 is arranged on the main part 12. The main part 12transitions into a fixed grip 19, and in the transition region from themain part 12 to the fixed grip 19 has a pivot 21, around which anactuatable grip 22 is swivel-mounted. As shown in FIG. 1, the actuatablegrip 22 and fixed grip 19 are assigned to each other in an initialposition 24 by a spring element 23. In this initial position 24, forexample, the functional elements 16, 17 are spaced apart from eachother. The represented grip, as well as a ring handle or furthervariants of grip can be understood by handle 18.

On actuating the grip 22, this is swung about the pivot 21, with themoveable part 14 being moved to the left in order to move the functionalelement 16 to the functional element 17. A working position is achievedas soon as these are resting against each other. As soon as theactuatable handle 18 is released, the moveable part 14 is movedindependently back to the initial position 24 due to the spring force ofthe spring element 23.

The moveable part 14 is led by a hinge joint 26 to the distal end of thesurgical instrument 11, and has at the proximal end, for example, aguide 27, which is represented in more detail in FIG. 4. Alternatively,a guide can only be intended in the central region of the main part 12and moveable part 14, or also there can be an additional guide. Forexample, a T-groove indentation 29 is intended as a guide 27 on the mainpart 12, in which a pilot pin 31 is engaged, and is longitudinallydisplaceable therein. Bordering the indentation 29, an input region 34is provided, which facilitates the insertion of the pilot pin 31 intothe indentation 29 on the completion of the moveable part 14 to the mainpart 12. After the moveable part 14 is positioned to the main part 12,the further guide 27 is produced, for example, as a hinge joint 26, inwhich, for example, a pin or screw is made through the moveable part 14for passage through a recess 32, in particular an oblong hole, in abracket 33 of the actuatable grip 22. In connection, the pin or thescrew can be slurred with an external side 36. A detachable arrangementof the hinge joint 26 for removing the moveable part 14 from the mainpart 12 for the cleaning and sterilising of the surgical instrument 11is not possible, and is also not necessary due to the embodiment of thesurgical instrument according to the invention.

A first embodiment of the surgical instrument 11 according to theinvention is shown enlarged in FIGS. 2, 3 and 4. The main part 12 has aguide surface 41 pointing to the moveable part 14. Opposite this, asliding surface 39 is assigned to the moveable part 14. During adisplacement movement of the moveable part relative to the main part 12,the sliding surface 39 can be moved along the guide surface 41, wherebythe sliding surface 39 and the guide surface 41 can be arranged witheach other for the formation of a small gap 42, or also lying on eachother, at least in portions, or also completely lying against eachother. In this first embodiment, for example, the moveable part 14 has asliding surface 39, which is open in at least a spatial direction. Inthis case, the moveable part 14 is opened or disconnected by a recess 37which is transverse in a longitudinal direction of the moveable part 14.According to FIG. 2, this recess 37 is crescent shaped. Preferably,several recesses 37 are installed next to each other, so that theserecesses 37 extend from a proximal end of the moveable part 14 to thedistal end of the moveable part 14. Thus it is particularly intendedthat the proximal recess reaches at least to the guide 27, or at leastmakes this partly accessible from outside. The same is valid for thehinge joint 26 in the distal region, so that this is also easilyaccessible for cleaning.

Surface portions 38 of the sliding surface 39 of the moveable part 14are formed between the recesses 37. The sliding surface 39 isconsiderably reduced by these surface portions 38 compared toconventional surgical instruments, where a continuous sliding surface 39is provided between the proximal and distal ends of the moveable part14. Opposite the sliding surface 39, a guide surface 41 is provided onthe main part 12. In the embodiment, this guide surface 41 isconstructed in a continuous manner with the exception of the indentation29 and the input region 34 bordering the indentation 29, and a distalend region, in which the bracket 33 of the actuatable grip 22 isarranged for actuating the surgical instrument 11. Alternatively, it canbe intended that the guide surface 41 features analogous recesses 37, orthe sliding surface 39 and the guide surface 41 feature recesses 37.Alternatively it can be intended that the moveable part 14 has acontinuous sliding surface 39 and the recesses 37 are only provided onthe guide surface 41. Equally, this can be intended alternately, so thata region of recesses 37 is provided on the guide surface 41,subsequently a region with recesses 37 on the sliding surface 39, andfurther subsequently a region with recesses on the guide surface 41.Combinations and arrangements are selectable in any way.

Through the embodiment of recesses 37 of this type, it is achieved thatthe surface portions 38 lying in between them are very small, at leastseen in the length in a longitudinal direction of the main part 12, withonly very narrow gaps 42 being formed between the sliding surface 39 andthe guide surface 41. Through this, a good and easier cleaning is madepossible. A rinsing of the gap 42 is also achieved simultaneously.Additionally, a visual check of the cleanliness is given. A surgicalinstrument 11 of this type also has good operating characteristics.Preferably, the sliding and/or guide surfaces 39, 41 are reduced to awidth of less than 70%, in particular less than 90% with regard to thewidth of the main part 12, or of the moveable part 14, or reduced byboth. A punctiform or linear allocation of the sliding and guidesurfaces 39, 41 to each other can also be provided.

Complementing these recesses 37, on one or both external sides 36 of themoveable part 14 and/or the main part 12, a bevel 43 can be provided,which in dependence upon the incline, determines the remaining width ofthe surface portions 38 of the sliding surface 39. Preferably, bevels 43of this type are provided symmetrically about the central axis 46 of themain part 12 and moveable part 14, so that both external sides 36 areequally formed. Provided that the bevels 43 are only arranged on themoveable part 14, for example, a triangular shaped hook results, wherebyon spraying the surgical instrument 11, a type of supply channel forrinsing the gaps 42 is given. The arrangement described above cananalogously also only be attached to the main part 12. The preferredembodiment according to FIG. 3 shows that the bevels are not onlyarranged symmetrically about the central axis 46, but also about themain part 12 and the moveable part 14. Through this, a particularlypreferable funnel-shaped arrangement for the supply of the cleaningagent for cleaning the gaps 42 is given. The course of the bevel 43 asstraight is only as an example. Further geometries are equally possible.

For example, in FIG. 3, the width of the guide surface 41, which ispreferably continuously formed from the distal to the proximal end ofthe main part 12, is formed as the same width as the surface portions 38of the sliding surface 39. Alternatively, one of both surfaces 39, 41can be constructed with a larger or smaller width. Additionally, it canbe intended, that for example, one of both surfaces 39, 41 is notconstructed in a planar manner, so that for example, planar surfaceportions 38 of the sliding surface 39 lie on a rounded guide surface 41.

The cross-sections shown of the moveable part 14 and the main part 12are only for example shown as a square or rectangular formed surfaceportion with rounded outer edges 48. These geometries can be developedin any way.

It is intended in an alternative embodiment not represented in detailthat the main part 12 and the moveable part 14, have in each case across-section according to FIG. 3, whereby the recesses 37 are notintroduced. An alternative embodiment of this type also makes itpossible to completely clean and sterilise the surgical instrument 11without disassembly. The gap 42, formed between the continuous slidingsurface 39 in a longitudinal direction, and equally continuous guidesurface 41, is small and cleanable in such a way that if necessary,bacteria accumulating therein can be washed out. Furthermore, it ispreferably intended that the width of the sliding surface 39 is formedas smaller than the width of the input region 34, so that this regionand the guide 27 can also be cleaned themselves. Additionally, theguides 27 for the slidable arrangement of the moveable part 14 to themain part 12 can be arranged in such a way that a lower gap height isformed.

An embodiment alternative to FIGS. 2 and 3 is shown in FIGS. 5 and 6. Inthis embodiment it is intended that the recess 37 or recesses 37 areconstructed in rectangular form. The surface portions remaining betweenthe recesses 37 are again formed to be small due to the bevels 43arranged on them. Then, for example, narrow, rectangular shaped surfaceportions 38 of the sliding surface 39 are constructed, which areoriented in a longitudinal extent of the surgical instrument 11. Theguide surface 41 is constructed, for example, wider than the surfaceportions 38 of the sliding surface 39.

A further embodiment alternative to FIGS. 2 and 3 is shown in FIGS. 7and 8. In this embodiment it is intended that the recess 37 is a zigzagshape or a triangular shape. Therefore once again a sufficiently largerfree space between the moveable part 14 and the main part 12 can beformed, in order to form washable gaps 42 between the surface portions38 of the sliding surface 39 and the guide surface 41.

A further embodiment alternative to FIGS. 2 and 3 is shown in FIGS. 9and 10. In this, it is intended that in the place of the straightrunning bevel 43, a crescent-segment curve is constructed, so that thesurface portions 38 of the sliding surface 39 lie almost in a line onthe guide surface 41. Once again, recesses 37 are formed lying inbetween, which are represented in this embodiment as rectangular shapedrecesses 37. Alternatively, arc shaped, triangular shaped forms or alsofurther geometric forms can be equally intended.

A further embodiment alternative to FIGS. 2 and 3 is shown in FIGS. 11and 12. In this embodiment it is intended that the recess 37 is formedby two truncated cone shaped elevations 50, which feature a rounded tip51, at which the surface portion 38 of the sliding surface 39 isprovided, which faces the main part 12 over the guide portion. In theprocess, the guide surface 41 is provided first of all with a bevel 43,from the external side 36, whereby both the bevels 43 sloping fromoutside to inside are connected to each other by a curvature or by adomed embodiment of the guide surface 41.

A further embodiment alternative to FIGS. 11 and 12 is shown in FIGS. 13and 14. In the process it is intended that the elevations 50 areconstructed in a semicircular form, and the guide surface 41 is a planarsurface. The width of the guide surface 41 of the main part 12 is againlimited by the bevels 43.

A further alternative embodiment is included in FIGS. 15 and 16. Thisembodiment is characterised by a bevel 43 which extends to the moveablepart 14 from an external side 36 almost to the other external side 36.Additional recesses 37 with different geometries can be intended inbetween. Provided that a bevel 43 of this type is provided on themoveable part 14 and preferably also on the main part 12, the remaininggap 42 is reduced to a minimum, with the gap bordering an external side36 of the main part 12 and the moveable part 14. Through this, it ismade possible simultaneously for the indentation 39 of the guide 37 tobe freely accessible. The embodiment can also be arranged rotated by180°.

A further alternative embodiment is included in FIGS. 17 and 18. Thisembodiment features a concave sliding surface 39 and a concave guidesurface 41, whereby two gaps 42 bordering the external side 36 areformed. For the cleaning of a middle channel of this type, againrecesses 37 are provided, preferably running transversely, which forexample are formed as rectangular shaped recesses 37. It is a matter ofcourse that also only one of both surfaces 39, 41 can feature a concaveembodiment. Equally, further geometric recesses can be introduced, inorder to obtain an analogous construction of this type according to thesectional representation in FIG. 18.

The above-mentioned embodiments show that any combinations in thegeometry of the guide surfaces 41 and the sliding surface 39 arepossible to form a washable gap 42, which remains between the recesses37.

An embodiment of a surgical instrument 11 alternative to FIG. 1 is shownin FIG. 19. In this alternative embodiment, the sliding surface 39and/or guide surface 41 is opened in a spatial direction other than thatin the above described embodiments. In this case the sliding surface 39and/or guide surface 41 is opened in a longitudinal direction of themain part 12 and the moveable part 14. Therefore, as is shown in FIG.20, it is made possible for a closed external side 36 of the main part12 and moveable part 14 to be formed. The recess 37 formed through thisin a longitudinal direction of the main part 12 and the moveable part 14is constructed as a channel 52, of which a cross-section is shown inFIG. 21, for example. A rear view of the moveable part 14 and the mainpart 12 is represented in FIG. 22. This recess 37 extends from aproximal end to a distal end of the surgical instrument 11 or proximalend of the moveable part 14 and main part 12 to the distal end of themoveable part 14 and main part 12. According to the representation inFIG. 21, the recess 37 has a roof-like shape, or constitutes atriangular shaped recess 37. The same is valid for the recess 37 in themain part 12. These recesses 37 in the main part and moveable partextend to the guides 27, so that these regions can also be cleaned oncleaning with a cleaning agent.

Alternative to the embodiment represented, a recess 37 can be providedeither only in the moveable part 14 or only in the main part 12, oralternately with at least a small overlap in each case. In each externaledge region of the moveable part 14 and of the main part 12, as shown inFIG. 21, a narrow gap 42 between the remaining sliding surface 39 andguide surface 41 is formed. The gap 42 is again washable from the insideout. Equally, it can be intended that a bevel 43 can again be arrangedon the parting plane on the external side, on one side ormirror-inverted, in each case on the parting plane between the slidingsurface 39 and the guide surface 41.

So that a cleaning inside of the input region in this embodiment is alsopossible, it is particularly intended that at least the indentation 39or the pilot pin 31 features a recess 37 extending in a longitudinaldirection. Preferably the indentation 39 as well as the pilot pin 31features a recess 37, so that this region can also be cleaned. This isshown as an example in FIG. 21.

The invention claimed is:
 1. Surgical instrument, in particular asliding shaft instrument, comprising a main part and a relative moveablepart, with a handle arranged on the main part, the former having a fixedgrip and a grip for actuating the moveable part, with at least one guidethrough which the moveable part relative to the main part is moveablebetween an initial position and a working position, and the moveablepart is guided at the distal end with a hinge joint, the moveable parthaving a sliding surface pointing to the main part, the sliding surfacebeing slidable along the guide surface pointing to the sliding surfaceand arranged on the main part, whereby the sliding surface and the guidesurface are arranged at least partially with each other for theformation of a washable gap, at least one of the sliding surface and theguide surface is opened by a recess extending transversely across thelongitudinal extent of the main part and moveable part and the recess isformed by two elevations arranged neighboring each other, in at leastone of truncated cone form, hemispherical form, and crescent segmentform.
 2. Surgical instrument according to claim 1, whereby on anexternal side of the main part or the moveable part, or on an externalside of the main part and the external side of the moveable part, abevel is provided bordering the guide surface or sliding surface, whichis sloped in at least portions to the longitudinal centre line of themain part and the moveable part.
 3. Surgical instrument according toclaim 1, whereby a bevel is provided on each external side of the mainpart and the moveable part, bordering the sliding surface or borderingthe guide surface.
 4. Surgical instrument according to claim 1, wherebyat least one recess or a bevel borders a guide.
 5. Surgical instrumentaccording to claim 4, whereby the bevel is constructedmirror-symmetrically about the longitudinal centre line of the moveablepart and main part, or mirror-symmetrically about the gap.
 6. Surgicalinstrument according to claim 1, wherein the recess is formed by twoelevations arranged neighboring each other in truncated cone form. 7.Surgical instrument according to claim 1, wherein the recess is formedby two elevations arranged neighboring each other in hemispherical form.8. Surgical instrument according to claim 1, wherein the recess isformed by two elevations arranged neighboring each other in crescentsegment form.